Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. The virus can spread from an infected person’s mouth or nose in small liquid particles when they cough, sneeze, speak, sing or breathe.

World Health Organization :

  • Post COVID rehabilitation comprises a multidisciplinary team led by a Rehabilitation Physician
  • The team is made up of physiotherapists, occupational therapists, speech and language
  • Therapists, psychologists, nurses, dieticians and pharmacists
  • Every member plays a role in looking at the multisystem impairment; with patient-centered goals

Aim :

  • Improve fitness
  • Reduce breathlessness
  • Increase muscle strength
  • Improve balance and coordination
  • Improve thinking
  • Reduce stress and improve mood
  • Increase confidence
  • Improve energy

Sign & symptoms :

The five most commonly reported symptoms were :

  • Fatigue
  • Exertional dyspnoea
  • Insomnia
  • Cough
  • Anxiety
  • Impaired lung function
  • Severe muscle weakness
  • Joint stiffness
  • Limited mobility and ability to do daily tasks
  • Delirium and other cognitive impairments
  • Difficulty swallowing and communicating
  • Mental health disorders and psychosocial support needs


  • Older Age - People of any age can catch COVID-19. But it most commonly affects middle-aged and older adults. The risk of developing dangerous symptoms increases with age, with those who are age 85 and older are at the highest risk of serious symptoms
  • Lung Problems, including asthma - Besides being an asthma trigger, smoking or vaping can harm your lungs and inhibit your immune system, which increases the risk of serious complications with COVID-19
  • Heart Disease - If you have high blood pressure, your risk may be higher if you don't control your blood pressure and take your medications as directed

  • Diabetes and Obesity - Diabetes and obesity both reduce how well a person's immune system works. Diabetes increases the risk of infections in general
  • Chronic Kidney or Liver Disease - Chronic kidney or liver disease can weaken your immune system, which may increase your risk of being seriously ill with COVID-19. Also, having serious COVID-19 symptoms and taking medications to treat the disease may have negative effects on the liver
  • Mental Health Condition - People with mental health conditions such as depression and schizophrenia spectrum disorders may be more likely to develop serious COVID-19 symptoms


  • 1. Manual Therapy for airway clearance : Aimed at loosening retained secretions from the airway walls :
    • Chest clapping / Percussion - Performed using a cupped hand with a rhythmical flexion and extension action of the wrist
    • Chest shaking - Course oscillations produced by the therapist’s hands compressing and releasing the chest wall.This technique augments expiratory flow and may help to mobilize secretion
    • Chest vibration - Fine oscillations applied to the chest wall by the therapist’s hands or fingertips (in babies).This technique augments expiratory flow and may help to mobilize secretion
  • 2. Strengthening and endurance exercise - During rehabilitation after a Covid-19 it is important to try to maintain cardiovascular endurance and strength

  • 3. Breathing exercise :
    • Diaphragmatic Breathing :
      • The patient sits in a comfortable, relaxed and supported position
      • One hand is placed on the chest while the other is on the abdomen
      • The patient is asked to breathe in slowly through the nose and then to breathe out through the nose
      • With each breath, the patient should appreciate the hand over the abdomen rising more than the hand over the chest
      • The patient is advised to use as little effort as possible and to ensure breaths are slow, relaxed, and smooth
      • Perform __repetitions per set and do __sets per day
    • Thoracic Mobility Exercise (TME) / Thoracic expansion exercise (TEE) :
      • The patient sits in a comfortable, relaxed and supported position
      • The patient slowly takes a deep breath while raising his arms towards the ceiling.
      • The patient is then instructed to hold his breath for 3 seconds
      • The arms are slowly brought down to the lap while breathing out through the mouth with a pursed lip
      • Perform__ repetitions per set and do __sets per day
    • Pursed Lips Breathing :
      • The patient sits in a comfortable, relaxed and supported position
      • Ensure that the neck and shoulder muscles are relaxed
      • The patient breathes in through the nose slowly for 2 counts, while keeping the mouth closed
      • The lips are pursed as if about to whistle or gently flicker the flame of a candle
      • The patient is then asked to breathe out slowly through pursed lips while counting to 4
      • This technique may be used in combination with the symptom relieving postures to ease dyspnoea
      • Perform__ repetitions per set and do __sets per day
    • Huffing Technique :
      • Huffing technique is a cycle of deep breathing, thoracic expansion and huff with the purpose of airway clearance
      • Huffing occurs through forced expiration with an open mouth
      • A huff is an active breath out with an open throat, like a sigh, as if trying to fog up a mirror
      • The patient is asked to perform a sequence of 23 deep breaths then 12 huffs, followed by a cough to clear any sputum
      • Perform__ repetitions per set and do __sets per day



Physiomobile Safety Checklist

  • Symptom-free therapist policies

  • Symptom-free client confirmation

  • All equipment to be thoroughly sanitized before each session

  • Only fully vaccinated therapists will be assigned to ensure mothers safety with PPEs appliance on duty

  • PPEs change by therapists between appointments

  • Deep cleaning and sanitizing of hands before contact

  • Sheets removal / disposal handling policy

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